Organization Active NPI

Mayra S Mahadin M D P C

  • Cardiovascular Disease Physician
  • Jackson Heights, NY
National Provider Identifier
1932394020
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
155360 Issued in NY
Legal business name
MAYRA S MAHADIN M D P C
Practice address
3757 91St St
Jackson Heights, NY 11372-7901
Phone
(718) 651-6500
Fax
(718) 651-0634
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mayra S Mahadin, M.D.NPI 1972511160
Title
Owner
Phone
(718) 651-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 155360 NY Primary

Addresses

Primary practice location

3757 91St St
Jackson Heights, NY 11372-7901

Mailing address

3757 91St St
Jackson Heights, NY 11372-7901
Phone (718) 651-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120308000058 NY Part B Supplier - Clinic/Group Practice 4082873211 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson Heights, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1932394020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3757 91ST ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727901",
            "telephone_number": "718-651-6500",
            "fax_number": "718-651-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3757 91ST ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727901",
            "telephone_number": "718-651-6500",
            "fax_number": "718-651-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYRA S MAHADIN M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "MAHADIN",
        "authorized_official_first_name": "MAYRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-651-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "155360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.